Individual provider · Type 1 NPI

Jaclyn Wallen

Mental Health Counselor · Berwyn, IL

NPI number 1083227995 Active

Practice location

6501 Stanley Ave
Berwyn, IL 60402-3123

Call (708) 484-7400 Map

Mailing address

5018 W 23rd St
Cicero, IL 60804-2927

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X180.008708 (IL)

Mental Health Counselor: Definition to come...

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About NPI 1083227995

Jaclyn Wallen's National Provider Identifier is 1083227995, issued on Aug 28, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Berwyn, IL. The record was last updated on Aug 28, 2020.